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Therapy Improves Outlook for Meth Abusers

New research suggests that offering methamphetamine abusers a behavioral therapy program called contingency management (CM — also known as Motivational Incentives) along with their usual care is more effective than the usual care alone.

Previous studies have shown the effectiveness of CM as a treatment for
stimulant abuse (primarily cocaine). A team led by Dr. John Roll of Washington
State University set out to see whether CM could help
methamphetamine abusers. Their study was supported by NIH’s National Institute
on Drug Abuse (NIDA) and conducted through NIDA’s National Drug Abuse Clinical
Trials Network, an infrastructure that tests the effectiveness of interventions
in community-based treatment settings.

CM applies rules and consequences to help people change their behavior. In
this case, the rules required production of drug-free urine samples. The rewards
were plastic chips that could be exchanged for prizes. The more the patients
followed the rules, the more chips they earned. If they didn’t follow the
rules, they lost chips. All 113 participants underwent usual care and were
randomized to receive either additional CM treatment or no additional treatment.

In the November 2006 issue of the American Journal of Psychiatry, the researchers report that participants who received CM in addition to treatment as usual submitted significantly more substance-free urine samples than participants who received only usual treatment during the 12-week study. Participants who were part of the CM program reported being continuously abstinent for an average of almost five weeks, while those who received the usual treatment were continuously abstinent an average of less than three.

Usual treatment was not the same at all the clinics, but at the one with the
largest proportion of participants, usual care consisted of the Matrix Model of
psychosocial treatment. The Matrix Model is a comprehensive treatment approach
including individual counseling, cognitive behavioral therapy, family education,
self-help programs and monitoring for drug use by urine testing. It’s currently
thought to be the most effective therapy for methamphetamine addiction.

While this study was fairly small, it suggests that combining CM with the
Matrix Model would give doctors an even more powerful weapon against
methamphetamine abuse.